利用MR扩散加权成像在鼻咽癌随访中帮助提高内窥镜活检价值的研究

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Abstract Objective: To improve the positive rate of endoscopic biopsy in follow-up of nasopharyngeal carcinoma(NPC) through MR diffusion weighted imaging. Methods: In the follow-up of NPC after treatment, 135 cases with suspicious recurrent were found negative result in the first endoscopic biopsy, then were performed with MR routine sequence and diffusion weighted sequence scanning before the second endoscopic biopsy. Through observing MR images, the positions of nasopharyngeal biopsy were decided, including MR-A location(MR routine sequence) and MR-B location(MR routine sequence and diffusion weighted sequence). In the second endoscopic biopsy, the tissue particle was obtained according to endoscope image(endoscopic location), and then each tissue particle was gotten according to MR-A and MR-B locations. The diagnostic value of the 3 kinds of locations and the influence of location consistency on the 2 kinds of MR locations were analyzed by comparing with the qualitative results. Results: in 135 cases, 56 cases were eventually confirmed for recurrence, 79 cases for no recurrence. Endoscopic location, MR-A location and MR-B location were found positive in 26 cases, 33 cases, 40 cases, negative in 109 cases, 102 cases, 95 cases, the sensitivity for 46.4%, 58.9%, 71.4%, the specificity all for 100%, Az values for 0.732, 0.795, 0.857. Because of the specificities all were 100%, the recurrence cases were analyzed. There was a correlation between the 2 kinds of MR locations(χ2=4.250, P=0.039, Kappa=0.265). In 56 cases with recurrence, biopsy sites of 2 MR locations were consistent in 32 cases and inconsistent in 24 cases. The consistency of biopsy directions had significant effects on the results of MR-A location(χ2=5.171, P=0.023, rp=0.304) and had no significant effects on the results of MR-B location(χ2=0.007, P=0.932, rp=0.011). When the biopsy directions were inconsistent, the positive rate of MR-A(41.7%, 10/24) was less than that of MR-B(70.8%, 17/24), there was significant difference(χ2=4.148, P=0.042). Conclusions: During the follow-up of NPC, MR assisted localization can help nasopharyngeal endoscope biopsy to improve the accuracy rate and reduce the misdiagnosis rate, and MR diffusion weighted imaging has greater value in the auxiliary positioning.

Key words： Nasopharyngeal neoplasms Diffusion magnetic resonance imaging Endoscopy

Received: 06 September 2015

PACS:	Ｒ739.63
	Ｒ445.2

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	Articles by authors
	LI Wei
	REN Zhi-gang
	TANG Ri-jie
	LU Bin-gui

Cite this article:

LI Wei,REN Zhi-gang,TANG Ri-jie, et al. The study of using MR diffusion weighted imaging to improve the value of endoscopic biopsy in#br# follow-up of nasopharyngeal carcinoma[J]. JOURNAL OF CHINA MEDICAL IMAGING, 2016, 27(5): 323-327.

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http://www.jccmi.com.cn/EN/ OR http://www.jccmi.com.cn/EN/Y2016/V27/I5/323

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